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Trial registered on ANZCTR
Registration number
ACTRN12608000541303
Ethics application status
Approved
Date submitted
10/09/2008
Date registered
27/10/2008
Date last updated
19/03/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
PressUre uLCers: Effectiveness of Risk assessment tools. A randomised controlled trial (the ULCER Trial)
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Scientific title
Among internal medical patients does screening with pressure ulcer risk assessment tools, compared with no screening, reduce the incidence of pressure ulcers.
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Secondary ID [1]
284288
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
The ULCER study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pressure ulcers
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Condition category
Condition code
Skin
4080
4080
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0
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Dermatological conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
There are two interventions which will be compared with standard practice. The first is not using any instrument to assess pressure ulcer risk. Patients in this group will not be screened and there will be no pressure ulcer screening instrument in their medical record. The second group will be screened on admission and weekly thereafter until hospital discharge using the Ramstatius tool, which contains only one question related to the patients ability to turn independently. Nurses will receive information about the instrument and advised to follow instructions on the form for frequency of re-screening.
The study will be conducted over a 12-month period
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Intervention code [1]
3607
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Prevention
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Comparator / control treatment
The Waterlow scale (standard practice) will be used for the initial screening to assess pressure ulcer risk. As this is a pragmatic trial, we will not screen again but it is possible that patients will be screened again during the course of their hospital stay (routine practice).
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Control group
Active
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Outcomes
Primary outcome [1]
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Patients will be reviewed at least second daily for the presence of any pressure ulcers. This will be undertaken by study nurses who will have received specific training in pressure ulcer grading.
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Assessment method [1]
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Timepoint [1]
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Patients will be reviewed at least second daily for the presence of any pressure ulcers. Development of a pressure ulcer at any time during an in-patient episode of care will be recorded.
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Secondary outcome [1]
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Length of hospital stay
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Assessment method [1]
8396
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Timepoint [1]
8396
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Time from admission to discharge will be recorded at patient hospital discharge.
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Eligibility
Key inclusion criteria
- Newly admitted to an Internal Medicine
ward
- Anticipated length of stay of at least 3
days
- Not having darkly pigmented skin
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Minimum age
18
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Must be free of pressure ulcers on admission
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients expected to remain in hospital for at least three days will be randomly assigned, within 24 hours of admission, to be screened with the Waterlow screening tool, the Ramstadius tool, or not screened at all. Following eligibility assessment, patients will be allocated to the Waterlow, Ramstadius, or clinical judgement group using a phone randomisation method.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer-generated randomized list will be produced to ensure allocation is unpredictable.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/02/2009
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Actual
15/04/2009
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Date of last participant enrolment
Anticipated
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Actual
15/12/2009
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
1070
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
3846
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Other Collaborative groups
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Name [1]
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Royal Brisbane and Women's Hospital (RBWH) Private Practice Trust
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Address [1]
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Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD 4029
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Country [1]
3846
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Australia
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Funding source category [2]
4070
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Charities/Societies/Foundations
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Name [2]
4070
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Royal Brisbane and Women's Hospital Research Foundation
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Address [2]
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PO Box 94
Royal Brisbane and Women's Hospital
QLD
Herston 4029
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Country [2]
4070
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Australia
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Primary sponsor type
Individual
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Name
Joan Webster
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Address
Level 2, Centre for Clinical Nursing
Royal Brisbane and Women's Hospital
Butterfield Street, Herston QLD 4029
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Country
Australia
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Secondary sponsor category [1]
3664
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Hospital
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Name [1]
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RBWH
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Address [1]
3664
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RBWH
Butterfirld Street
Herston 4029
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Country [1]
3664
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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RBWH Human Research Ethics Committee
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Ethics committee address [1]
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RBWH Butterfirld Street Herston 4029
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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28/09/2008
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Approval date [1]
6141
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Ethics approval number [1]
6141
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RBWH 2008/143
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Summary
Brief summary
Pressure ulcer development is a significant risk for hospitalised patients and health care facilities. Pressure ulcer related costs in Australia have been estimated at $285 M per annum. Preventative measures are generally based on estimating the patient’s risk, using screening tools such as the Waterlow scale. Despite the widespread use of the Waterlow scale as an intervention to prevent pressure ulcers, its effectiveness has never been tested using rigorous methods. We propose to conduct a three group, single centred randomised controlled trial to compare the Waterlow Scale, with a simpler, one item measure; and with clinical judgement. We will also investigate risk factors for pressure ulcer development in an acute hospital setting.
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Trial website
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Trial related presentations / publications
Webster J, Coleman K, Gardner G, Mudge A, Stankiewicz M, Kirby J, Vellacott C, Horton-Beshers M, McClymont A. PressUre uLCers: Effectiveness of Risk assessment tools. A randomised controlled trial (the ULCER Trial). BMJ Quality & Safety in Health Care 2011; 20(4):297-306
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Public notes
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Contacts
Principal investigator
Name
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Prof Joan Webster
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Address
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Level 2, Bld 34
RBWH
Butterfield St
Herston QLD 4029
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Country
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Australia
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Phone
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+ 61 7 3646 8590
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Joan Webster
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Address
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Level 2, Centre for Clinical Nursing
Royal Brisbane and Women's Hospital
Butterfield Street
Herston QLD 4029
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Country
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Australia
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Phone
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(07) 3636 8590
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Fax
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Email
12073
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[email protected]
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Contact person for scientific queries
Name
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Joan Webster
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Address
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Level 2, Centre for Clinical Nursing
Royal Brisbane and Women's Hospital
Butterfield Street
Herston QLD 4029
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Country
3001
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Australia
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Phone
3001
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(07) 3636 8590
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Fax
3001
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Email
3001
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Pressure ulcers: Effectiveness of risk-assessment tools. A randomised controlled trial (the ULCER trial).
2011
https://dx.doi.org/10.1136/bmjqs.2010.043109
N.B. These documents automatically identified may not have been verified by the study sponsor.
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